Organization
LIFE SERVICE PROFESSIONAL CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GERALDINE BARRON-SIMPSON (OFFICE MANAGER)
(219) 938-0920
Entity
Organization
Contact information
Practice address
1015 N SHELBY ST, GARY, IN 46403-1446
(219) 938-0920
(219) 938-0923
Mailing address
1015 N SHELBY ST, GARY, IN 46403-1446
(219) 938-0920
(219) 938-0923
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
IN
Other
Enumeration date
08/17/2006
Last updated
07/21/2022
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